St. Paul daily globe. [volume] (Saint Paul, Minn.) 1884-1896, 1887-10-05

SurprlSeS-tne uneX-
~ "a pected and the I'M
kSE S# looked for occur about
E$4 v u as often as in any
AN -Sother place, and a
~ - surgeon may stumble
~ upon something that
(IS will surprise him in
S4Se - ordinary cases which
- &ay appear simple and
easily eXplainable.
An exhibition of this was given last
week in the case of Mary Hoiske, a
middle-aged woman, who was brought
to the New York hospital. The patient
had been i'll about wo months before
her admission to the hospital. The
origin of her trouble was fall, or at
least that is what the woman believed.
While walking in the dark she tripped,
fell, and her neck struck violently upon
a chair The flesh in her neck turned
black from the blow, and was sore and
painful. She had some difficulty in
swallowing after the injury.
About Il week afterward, while drink
ing, she suddenly chOked and coughed
as people do when foreign body passes
into the windpipe. The spasmodic con-
traction of the throat was so great that
the woman nearly died from suffocation,
but nature finally brought relief without
we're pounding on the back.
The woman was never we'll after this.
There was always an annoying.
PAIN IN HER THROAT.
She described the feeling as reSem-
bling a boring machine at work in
her neck. A heavy weight seemed to
be pressing upon her head, and, as
usual. when this feeling is present, the
wOman's mental condition was soon I'M
balanced and she was possessed OF the
most frightful decisions. She had an
idea that her feet were useless; that
when moving around she walked on her
hands, and when she was quiet she
stood on her head. This, to her mind,
was the cause of the pressure on her
neck.
Her ailment was thought at first to be
due to the introduction of some foreign
body in the larynx. The symptoms and
spaSms that she had endured were be-
lieved to result from this cause. The
laryngoscope was called into play and
careful examination was made of the
larynx, without, however, giving any
explanation of the difficulty. A slight
swelling appeared in the neck just
above the breast bone. The pain
increased and there were frequent
spasms. Solid food could not be
swallowed at all, and liquid food was
not an easy thing to take. The pain
seemed to dart from the neck to the mid
die of the back. Her skin took on the
yellow hue that is common to patients
with jaundice, though the liver was not
at all affected. When food was given it
was always followed by great prostra
ton. The woman, who was stout and
weighed 200 pounds, lost flesh so rap
idly that it could almost be seen to
leave her bones. She was reduced to a
skeleton and her strength was gone ell
tirely. ParoXysms came on frequently,
during which She would utter cries
LIKE A WILD ANIMAL.
She was taken to the hospital when
there was no hope of life, being delir-
iouS and entirely unconscious of her
surroundings. DR.. Rice, to whom she
was assigned, looked upon her as little
better than dead woman. He studied
her history carefully, and came to the
conclusion that she was sufferig from a
carcinoma, or cancer of eSOphagus.
She was in such reduced state that it
was not thought possible to do anything
for her. She was put into cot with
the same idea that an old horse is
turned out to grass-that is, to die.
But she did not die, and after several
days her vitality seemed to improve
slightly, and an operation was decided
upOIl. lilC OUJCCb VI WHICH, was W
portion of the RSOphaguS, in the hope
fprOlOnging the wOman's life, although,
taking her condition into consideration,
it were better that she were dead. She
was taken to the operating room. Only
small quantity of ether was given, as
the woman was unconscious. and the
only object in giving the an8sthetic was
to reduce the shock. An incision was
made in the right side of her neck about
five inches long. The head of the pa
tient was drawn backward so as to make
the muscles in the throat prominent.
The sternO mastoid muscle was taken
as a guide, and the incision was
made in the depression between
the the larynx and this mus
Gle. The flesh was divided with the
utmost caution in order to avoid the
large blOod-vesselS in the neck, any
laceratiOn of which might prove almost
instantaneouSly fatal. The sheath of
the carotid was found to be somewhat
out of the usual position. A retractor
was placed under the sheath and it and
the sterno mastoid were drawn back
ward. The larynx was pulled in the
opposite direction with a retractor to
open the wound. A slender instrument
was passed into the mouth and intro
duced into the RsOphague and pressed
outward so as to indicate the true posi-
ton. The flesh around it being eau
tiously removed,
THE GSoPHAGUs WAS EXPOSED
at considerable length. But there was
no sign of disease in the upper portion
of it, where cancers are usually found.
The incision was extended downward,
and every hairs breadth that the knife
descended was examined in order that
there might be no slip. All the large
arteries were avoided with great skill.
Before the breaSt-bOne was reached the
GsOphaguS and neighboring tissue was
found to be inflamed. By carving the
incisiOn q little below the bone it was
discovered that hole had been eaten
through the nsophagus by liberation.
There were no signs of cancerouS infil-
tratiOn in the tissue, and the ulcer evil
IDENTIFY was not malignant.
1t extended in the tissue downward and
backward and left small passage in it.
as if an artificial duct had been made.
The surgeon, having an exceedingly
small hand, was able to pass his finger
through this passage at considerable
length, and was aStOniShed to find a
hard substance. 1t was lodged in the
cavity of the pericardium and pressed
against the breast. A small fOrceps
with a curved lower section and serrated
edge was gently passed into the cavity.
After many failures the substance was
caught firmly and drawn out.
The surgeon was astounded
to find large false tooth
attached to broken piece of plate.
The tooth had been swallowed unknown
to the patient, had lodged in the 9sOpha-
gus and liberated into the pericardium,
and this had caused her agony, and not
the fall, as was supposed.
Fortunately the removal of the tooth
set up only slight hemorrhage, and the
blood was quickly absorbed by sponges.
AS much of the liberated surface as was
visible was sprayed with carbolc acid